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TEACH Educational Rounds Going Underground with Smoking Cessation That Works

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TEACH Educational Rounds Going Underground with Smoking Cessation That Works #TEACHwebinar TEACH Educational Rounds Going Underground with Smoking Cessation that Works Faculty Presenter: Amanda Gauthier PHN BScN AFFILIATIONS Algoma Public Health Date: January 29, 2020 Educational Rounds 2020 1 #TEACHwebinar Interested in Obtaining a Letter of Completion for this TEACH Educational Rounds? Requirements: 1. Registered for the webinar & complete Pre- Learning Assessment 2. Sign-in to view/participant in the live webinar session using your FIRST and LAST name. 3. Complete Evaluation and Post- Learning Assessment Educational Rounds 2020 2 #TEACHwebinar • These webinars are being live tweeted on Twitter • Follow the CAMH Nicotine Dependence Service on Twitter: @PSQuitSmoking • To follow the live tweeting or to post your questions or comments using Twitter follow: #TEACHwebinar Educational Rounds 2020 3 #TEACHwebinar Presenter Biography Amanda Gauthier RN BScN [email protected] Amanda has worked at Algoma Public Health since 2011. She grew up in Wawa Ontario and has a passion for advocating for health and wellness needs in the north. Amanda worked at Lady Dunn Health Centre where she experienced caring for patients with COPD, emphysema and lung cancer related to smoking. Amanda currently works in the Healthy Growth and Development program at Algoma Public Health. She continues to collaborate with community partners on the goal of reducing smoking rates by 5% in 5 years in Algoma. Educational Rounds 2020 4 Disclosures #TEACHwebinar Faculty/Presenter Disclosure . Research Assistance – STOP Study (Smoking Treatment for Ontario Patients) – Ontario Tobacco Research Unit Disclosure of Financial Support . STOP program funded the NRT for the project. Potential Conflict(s) of Interest . No Disclosures Educational Rounds 2020 5 #TEACHwebinar Disclosures Potential sources of bias outlined on the following slide have been mitigated by making this information accessible and available to all participants. Educational Rounds 2020 6 #TEACHwebinar TEACH Curriculum Development Content of the TEACH Curriculum slides are primarily based on evidence based guidelines including: • CAN-ADAPTT Canadian Practice Guidelines Initiative – developed in collaboration with national experts in tobacco cessation and health behaviour change (www.can-adaptt.net) • US Guidelines Treating Tobacco Use and Dependence: Clinical Practice Guideline 2008 Update. US Department of Health and Human Services, Public Health Service • Rethinking Stop-Smoking Medications: Treatment Myths and Medical Realities OMA Position Paper, January 2008. The development and delivery of the TEACH curriculum is not influenced or funded in any part by tobacco industry. TEACH has not received funding from the tobacco industry. The development of the TEACH curriculum has not been influenced by pharmaceutical industry. Information presented on pharmacotherapy refers to generic products only, and recommendations are based on existing research, including the CAN-ADAPTT and US guidelines. Educational Rounds 2020 7 #TEACHwebinar Disclaimer These materials (and any other materials provided in connection with this presentation) as well as the verbal presentation and any discussions, set out only general principles and approaches to assessment and treatment pertaining to tobacco cessation interventions, but do not constitute clinical or other advice as to any particular situations and do not replace the need for individualized clinical assessment and treatment plans by health care professionals with knowledge of the specific circumstances. Educational Rounds 2020 8 #TEACHwebinar Copyright Copying or distribution of these materials is permitted providing the following is noted on all electronic or print versions: © CAMH/TEACH No modification of these materials can be made without prior written permission of CAMH/TEACH. Educational Rounds 2020 9 #TEACHwebinar Learning Objectives 1. Explain how a tobacco cessation program (STOP Program) was adapted to meet the needs of employees at a rural northern Ontario worksite. 2. Identify some of the challenges and opportunities associated with the delivery of smoking cessation services at worksites. Educational Rounds 2020 10 #TEACHwebinar The Spark Spring of 2017 • The upcoming legalization of cannabis sparked interest and concern at Alamos Gold Inc., who had in place a strict no smoking (cigarettes) policy except for in designated areas. • Alamos management approached their Occupational Health Nurse to develop a plan to offer tobacco cessation services to interested employees. • The Occupational Health Nurse reached out to Algoma Public Health Wawa office. Educational Rounds 2020 11 #TEACHwebinar The Need • Algoma District has high smoking rates* • Algoma Public Health (APH) collaborated with community partners to reduce smoking rates by 5% in 5 years (2020). • Alamos Gold Inc. is a partner. • The Occupational Health Nurse estimated the smoking rate at Alamos at approximately 38%. • At Alamos, smoking was taking place in areas other than the designated smoking areas. Educational Rounds 2020 12 #TEACHwebinar Wawa APH Smoking Cessation • Emma Blanchet – Psychiatric Case Manager – Community Mental Health Services • Amanda Gauthier – Public Health Nurse • Role of APH Wawa cessation to fill a gap, not duplicate services in the community. • Wawa, cessation clinic had very few clients. Educational Rounds 2020 13 #TEACHwebinar Key Partners • Alamos Mine - Occupational Health Nurse • Alamos Mine – Management & Employees • STOP program and STOP Coordinator • Ontario Tobacco Research Unit (OTRU) • Algoma Public Health - Tobacco Cessation Program Staff • Algoma Public Health - Management Educational Rounds 2020 14 #TEACHwebinar Key Input May 2017 – site visit • Presentation – CO monitor • Discussion with employees • Feedback on their needs • Occupational Health Nurse ++ involved Educational Rounds 2020 15 #TEACHwebinar Challenges: Location • Alamos Island Gold Inc., near Dubreuilville in remote northern Ontario location. Educational Rounds 2020 16 #TEACHwebinar Challenges: Access • Employer drug coverage benefits for nicotine replacement therapy required a physician’s prescription, and was limited. • Limited access to a pharmacy to purchase nicotine replacement therapy products during work schedule. • Employees requested tobacco cessation services. – Scheduled at worksite – Convenient appointments Educational Rounds 2020 17 #TEACHwebinar Challenges • Employee schedules vary, e.g. some shift workers do 7 in 7 out at a time. • Employees from all over the area, Dubreuilville, Wawa, White River, Blind River, etc. Educational Rounds 2020 18 #TEACHwebinar Challenges • Mine changed ownership during project time. • Occupational Health Nurse was planning to retire and new Occupational Health Nurses stepping into role. Educational Rounds 2020 19 #TEACHwebinar Who Are We Helping? • Majority men age 20 -50 years old • High School, College education • Earning good income • Hard working • Some individuals reported minimal involvement with health care providers • Individuals reported that for some smoking took place at work, and for some at home. Educational Rounds 2020 20 #TEACHwebinar What Could We Offer? • STOP on the Road funding not available • STOP with Addictions Program – APH has a Community Alcohol and Drug Assessment Program and provides the STOP with Addictions tobacco cessation program – 26 Weeks of nicotine patches and/or short acting NRT – Fit the program into the employees schedule • Shift work 7 days in and 7 days out + other schedules Educational Rounds 2020 21 #TEACHwebinar The Pitch • Business case to Employer (Alamos Gold Inc.) – Determine how many employees would use program – Cost – No smoking policy – easier to support with a tobacco cessation program available. – Healthier employees = ++ benefits, productivity, less absenteeism etc. • APH goal was to help initiate and support Alamos in the development of a workplace smoking cessation program. Educational Rounds 2020 22 #TEACHwebinar Making It Work September 2017: 2 site visits – Brief presentation (10 min), registration in STOP program and dispense NRT – Presentation & Registration: • 3 p.m. dayshift ends • 6:30 p.m. night shift coming in – Dispense 4 weeks of NRT – Phone call scheduled 2 weeks after registration for each shift – Occupational Health Nurse coordinated phone calls on Wednesdays Educational Rounds 2020 23 #TEACHwebinar Schedule Date Time Crew Activity May 24, 2017 4:40 & 6:45 A & B Presentation Sept. 6, 2017 3:30 Dayshift Crew C Presentation, enrollment in STOP Sept. 6, 2017 6:30 Nightshift Crew D Presentation, enrollment in STOP Sept. 13, 2017 3:30 Dayshift Crew A Presentation, enrollment in STOP Sept. 13, 2017 6:30 Dayshift Crew B Presentation, enrollment in STOP Sept. 20, 2017 3:30 & 6:30 Crew C & D Phone call with employee & Occ. (Wednesday) Health Nurse. STOP visit form NRT sent to Occ. Health Nurse. Sept. 27, 2019 3:30 & 6:30 Crew A & B Phone call with employee & Occ. (Wednesday) Health Nurse. STOP visit form. NRT sent to Occ. Health Nurse. Continues: phone calls every 2 weeks for each shift for 26 weeks of STOP program Educational Rounds 2020 24 #TEACHwebinar Modify and Adapt • Flexible APH staff schedule • Mental Health Worker involved in project • Creative with the timing of the program and follow up phone calls • Try something new & connection with a workplace • Collaborate with partners (Occupational Health Nurse) Educational Rounds 2020 25 #TEACHwebinar Short Term Goals 1. Assist current smokers with a quit attempt – Objectives: • enroll 8 employees
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